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Published in: BMC Palliative Care 1/2024

Open Access 01-12-2024 | Constipation | Research

A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit

Authors: Ragnhild Elisabeth Monsen, Anners Lerdal, Hilde Nordgarden, Caryl L. Gay, Bente Brokstad Herlofson

Published in: BMC Palliative Care | Issue 1/2024

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Abstract

Background

Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an “Other problem”.

Methods

This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one “Other problem”. Seven similar symptoms were listed in both versions.

Results

In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and < 1%, respectively. Although ESAS-r severity scores for these three symptoms were higher than on ESAS-m, differences did not reach statistical significance.

Conclusion

We identified significant differences in patient symptom reporting based on whether symptoms like dry mouth, obstipation and sleep problems were specifically assessed or had to be added by patients as an “Other problem”.
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Literature
3.
go back to reference Henson LA, Maddocks M, Evans C et al. Palliative care and the management of common distressing symptoms in advanced cancer: Pain, breathlessness, nausea and vomiting, and fatigue. J Clin Oncol. 2020:JCO. 19.00470. Henson LA, Maddocks M, Evans C et al. Palliative care and the management of common distressing symptoms in advanced cancer: Pain, breathlessness, nausea and vomiting, and fatigue. J Clin Oncol. 2020:JCO. 19.00470.
12.
go back to reference Bausewein C, Daveson BA, Currow DC, et al. EAPC White Paper on outcome measurement in palliative care: improving practice, attaining outcomes and delivering quality services - recommendations from the European Association for Palliative Care (EAPC) Task Force on Outcome Measurement. Palliat Med. 2016;30(1):6–22. https://doi.org/10.1177/0269216315589898.CrossRefPubMed Bausewein C, Daveson BA, Currow DC, et al. EAPC White Paper on outcome measurement in palliative care: improving practice, attaining outcomes and delivering quality services - recommendations from the European Association for Palliative Care (EAPC) Task Force on Outcome Measurement. Palliat Med. 2016;30(1):6–22. https://​doi.​org/​10.​1177/​0269216315589898​.CrossRefPubMed
15.
go back to reference Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991.
21.
go back to reference Kirkova J, Walsh D, Rybicki L, et al. Symptom severity and distress in advanced cancer. Palliat Med. 2010;24(3):330–9.CrossRefPubMed Kirkova J, Walsh D, Rybicki L, et al. Symptom severity and distress in advanced cancer. Palliat Med. 2010;24(3):330–9.CrossRefPubMed
22.
go back to reference Rojas-Concha L, Petersen MA, Groenvold M. Characteristics of patients reporting symptoms by open-ended questions in specialist palliative care. Dan Med J. 2021;68:8. Rojas-Concha L, Petersen MA, Groenvold M. Characteristics of patients reporting symptoms by open-ended questions in specialist palliative care. Dan Med J. 2021;68:8.
24.
go back to reference Watanabe SM, Nekolaichuk C, Beaumont C, et al. A multicenter study comparing two numerical versions of the Edmonton Symptom Assessment System in palliative care patients. J Pain Symptom Manage. 2011;41(2):456–68.CrossRefPubMed Watanabe SM, Nekolaichuk C, Beaumont C, et al. A multicenter study comparing two numerical versions of the Edmonton Symptom Assessment System in palliative care patients. J Pain Symptom Manage. 2011;41(2):456–68.CrossRefPubMed
27.
28.
go back to reference Strömgren AS, Sjogren P, Goldschmidt D, et al. Symptom priority and course of symptomatology in specialized palliative care. J Pain Symptom Manage. 2006;31(3):199–206.CrossRefPubMed Strömgren AS, Sjogren P, Goldschmidt D, et al. Symptom priority and course of symptomatology in specialized palliative care. J Pain Symptom Manage. 2006;31(3):199–206.CrossRefPubMed
29.
go back to reference Teunissen SC, Wesker W, Kruitwagen C, et al. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007;34(1):94–104.CrossRefPubMed Teunissen SC, Wesker W, Kruitwagen C, et al. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007;34(1):94–104.CrossRefPubMed
34.
go back to reference Hui D, Bruera E. The Edmonton Symptom Assessment System 25 years later: past, present, and future developments. J Pain Symptom Manage. 2017;53(3):630–43.CrossRefPubMed Hui D, Bruera E. The Edmonton Symptom Assessment System 25 years later: past, present, and future developments. J Pain Symptom Manage. 2017;53(3):630–43.CrossRefPubMed
35.
go back to reference Oldenmenger WH, Pleun J, de Klerk C, van der Rijt CC. Cut points on 0–10 numeric rating scales for symptoms included in the Edmonton Symptom Assessment Scale in cancer patients: a systematic review. J Pain Symptom Manage. 2013;45(6):1083–93.CrossRefPubMed Oldenmenger WH, Pleun J, de Klerk C, van der Rijt CC. Cut points on 0–10 numeric rating scales for symptoms included in the Edmonton Symptom Assessment Scale in cancer patients: a systematic review. J Pain Symptom Manage. 2013;45(6):1083–93.CrossRefPubMed
36.
go back to reference Hui D, Shamieh O, Paiva CE, et al. Minimal clinically important difference in the physical, emotional, and total symptom distress scores of the Edmonton Symptom Assessment System. J Pain Symptom Manage. 2016;51(2):262–9.CrossRefPubMed Hui D, Shamieh O, Paiva CE, et al. Minimal clinically important difference in the physical, emotional, and total symptom distress scores of the Edmonton Symptom Assessment System. J Pain Symptom Manage. 2016;51(2):262–9.CrossRefPubMed
48.
go back to reference Jakobsen G, Gjeilo KH, Hjermstad MJ, Klepstad P. An update on Prevalence, Assessment, and risk factors for sleep disturbances in patients with Advanced Cancer-implications for Health Care providers and Clinical Research. Cancers (Basel). 2022;14(16). https://doi.org/10.3390/cancers14163933. Jakobsen G, Gjeilo KH, Hjermstad MJ, Klepstad P. An update on Prevalence, Assessment, and risk factors for sleep disturbances in patients with Advanced Cancer-implications for Health Care providers and Clinical Research. Cancers (Basel). 2022;14(16). https://​doi.​org/​10.​3390/​cancers14163933.
53.
go back to reference Fischer D, Epstein J, Yao Y, Wilkie D. Oral health conditions affect functional and social activities of terminally ill cancer patients. Support Care Cancer. 2014;22(3):803–10.CrossRefPubMedPubMedCentral Fischer D, Epstein J, Yao Y, Wilkie D. Oral health conditions affect functional and social activities of terminally ill cancer patients. Support Care Cancer. 2014;22(3):803–10.CrossRefPubMedPubMedCentral
Metadata
Title
A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit
Authors
Ragnhild Elisabeth Monsen
Anners Lerdal
Hilde Nordgarden
Caryl L. Gay
Bente Brokstad Herlofson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2024
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-024-01405-7

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